Association between increased body mass index and self-reported asthma in the Puerto Rican population

The prevalence of asthma appears to be higher among obese subjects, and a link between these chronic conditions has been postulated. To evaluate the association between an elevated body mass index (BMI) and a diagnosis of self-reported asthma among Puerto Rican adults, data on 25,039 subjects aged 18 years and older who participated in the 2003 Continuous Health Survey for the Municipalities of Puerto Rico was analyzed. A probability sample of 16,617 households representative of each of the 78 municipalities of Puerto Rico was selected using a multistage stratified cluster sampling design. Logistic regression, stratified by sex, was used to examine the association between asthma prevalence and BMI category (normal: 18.5-24.9 kg/m2; overweight: 25.0-29.9 kg/m2; obese: ≥30.0 kg/m2) adjusting for age, education level, health insurance, smoking status and drinking status. Prevalence of self-reported asthma was 8.8% (95% CI: 8.4%-9.2%), 6.5% for men (95% CI: 6.2%-6.8%) and 10.9% for women (95% CI: 10.5%-11.3%). Compared to women with a normal BMI, overweight and obese women had a significant higher odds of asthma [overweight: POR=1.23 (95% CI: 1.07-1.42); obese: POR=1.92 (95% CI: 1.67-2.21)] after adjusting for age, education level, health insurance, smoking status and drinking status. However, the association between BMI category and prevalence of asthma among males did not reach statistical significance (p>0.05). The current study closely agrees with other investigations that have documented an excess of asthma among obese individuals. Additional research is needed to further elucidate the pathogenesis and temporal sequence between obesity and asthma.